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Having just returned from Europe, I was reminded of just how many people around the globe continue to smoke.

e-Cigarettes: what you need to know

Dr Ross Walker
10 June 2014

by Ross Walker

Having just returned from Europe, I was reminded of just how many people around the globe continue to smoke, but, also the increasing use of e-Cigarettes i.e. electronic cigarettes which provide nicotine using a battery-powered heating element activated by suction to heat a nicotine solution to transform it into vapour. 

Firstly and most importantly, apart from, say jumping out of a plane without a parachute, one of the most dangerous things you can do for your health and wellbeing is to smoke cigarettes.  There is an estimated six million deaths around the globe per year related to cigarette smoking.  Nicotine is the addictive component of cigarette smoke but the least poisonous of the 48 serious poisons you ingest into your body with every cigarette.

It is my view that cigarettes should be banned entirely, but we all know that this is not going to happen.  So, are e-Cigarettes the answer?  Are they safe?  Do e-Cigarettes assist in the ultimate cessation of all nicotine containing products and this question may surprise you; does being addicted to nicotine actually cause you any harm and shock horror! – could there be any benefits from the use of nicotine alone without the proven toxins in cigarettes? 

So firstly to respond to the question: Are e-Cigarettes the answer?  A relatively recent study from the Journal of the American Medical Association has suggested that e-Cigarettes had little effect on smoking cessation.  The survey asked 950 smokers the following questions:

  1. How many cigarettes do you smoke per day?
  2. What time in the day do you have your first cigarette?
  3. Do you intend quitting?
  4. Have you used e-Cigarettes in the last thirty days?

13.5% of those surveyed did quit during the period of the survey and e-Cigarettes basically had no affect on the quit rate. But, the much larger WEST study from the UK published in the Journal Addiction recently looked at 5,800 smokers over a five year period who attempted quitting without prescription medicine or support. Twenty per cent of those using e-Cigarettes stopped smoking compared with only ten per cent who used the nicotine replacement therapy i.e. the patches and the gum and fifteen per cent who were able to quit without any help whatsoever. 

The next question is: Are e-Cigarettes safe?

Firstly, e-Cigarette use in the US and Europe in 2010 was only two per cent of smokers but in 2012, it climbed to thirty per cent.  There is some evidence for an effect on the lungs and also the calls to poison centres involving e-Cigarette liquids containing nicotine increased from one call per month in 2010 to 215 calls per month in 2014.  Fifty per cent of these calls involved accidental poisoning in children below the age of five. 

Also, we have no real idea about any potential for long term harm which is, no doubt, well established in conventional cigarettes. 

Finally, the very unanswered question as to the inherent harm from nicotine itself? Although, no doubt, very addictive, there is not much evidence that nicotine alone without the very harmful delivery system of a cigarette has any serious harmful affects in average doses seen in nicotine replacement therapy. I have a number of anecdotal cases of ex-smokers still regularly use a nicotine gum with no obvious ill effects. 

Some poorly controlled trials have even suggested lower rates of Alzheimer’s Disease and Parkinsons in smokers because of the nicotine. This is, of course, no justification for smoking or chronic nicotine use. 

I would suggest, at this stage, there are too many unanswered questions to encourage the use of e-Cigarettes over nicotine replacement therapy but there is also no doubt that the worst choice is to continue smoking conventional cigarettes and this is where our major focus of concern should always be.

To quit smoking visit the iCanQuit website here.

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